The global epidemiology and burden of opioid dependence: results from the global burden of disease 2010 study
The global epidemiology and burden of opioid dependence: results from the global burden of disease 2010 study
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DOI：
10.1111/add.12551
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发表时间：
2014-08-01
期刊：
影响因子：
6
通讯作者：
Vos, Theo
中科院分区：
文献类型：
--
作者：
Degenhardt, Louisa;Charlson, Fiona;Vos, Theo
旨在估计全球、区域和国家一级阿片类药物依赖所致疾病的流行率和负担。方法采用多种检索策略：(1)同行评议文献检索；(2)网上数据库系统检索；(3)网络检索；(4)专家咨询和反馈。挑选和数据提取遵循协议。DisMod-MR是最新版本的通用疾病建模系统，是一种贝叶斯元回归工具，按年龄、年份和性别对187个国家和21个地区的流行率进行了估算。通过人口调查估计阿片类药物依赖的残疾权重，并乘以流行数据，以计算残疾生活年数。阿片依赖过早死亡率计算为减寿年数(YLLS)，并与减寿年数相加计算伤残调整寿命年(DALY)。结果2010年全球有1550万阿片类药物依赖者[0.22%，95%不确定区间=0.20-0.25%]。年龄标化患病率男性(0.30%，95%UI=0.27~0.35%)高于女性(0.14%，95%UI=0.12~0.16%)，高峰出现在25~29岁。患病率高于澳大利亚(0.46%，95%UI=0.41-0.53%)、西欧(0.35%，95%UI=0.32-0.39)和北美(0.30%，95%UI=0.25-0.36)的全球综合患病率。据估计，2010年全球对阿片类药物依赖的DALYs为920万(占全球DALYs的0.37%)，比1990年估计的DALYs增加73%。阿片依赖DALY比率最高的地区是北美(292.1/10万)、东欧(288.4/10万)、澳大拉西亚(278.6/10万)和撒哈拉以南非洲南部(263.5/10万)。在北美、东欧和撒哈拉以南非洲南部，YLLS对阿片依赖负担的贡献尤其大。结论阿片类药物依赖是造成全球疾病负担的重要因素；其对过早死亡(相对于流行率)的贡献因地区而异，其中北美、东欧和撒哈拉以南非洲受影响最大。
Aims To estimate the prevalence and burden of disease attributable to opioid dependence globally, regionally and at country level. Methods Multiple search strategies: (i) peer-reviewed literature searches; (ii) systematic searches of online databases; (iii) internet searches; (iv) consultation and feedback from experts. Culling and data extraction followed protocols. DisMod-MR, the latest version of the generic disease modelling system, a Bayesian meta-regression tool, imputed prevalence by age, year and sex for 187 countries and 21 regions. Disability weight for opioid dependence was estimated through population surveys and multiplied by prevalence data to calculate the years of life lived with disability (YLDs). Opioid dependence premature mortality was computed as years of life lost (YLLs) and summed with YLDs to calculate disability-adjusted life years (DALYs). Results There were 15.5 million opioid-dependent people globally in 2010 [0.22%, 95% uncertainty interval (UI) = 0.20-0.25%]. Age-standardized prevalence was higher in males (0.30%, 95% UI = 0.27-0.35%) than females (0.14%, 95% UI = 0.12-0.16%), and peaked at 25-29 years. Prevalence was higher than the global pooled prevalence in Australasia (0.46%, 95% UI = 0.41-0.53%), western Europe (0.35%, 95% UI = 0.32-0.39) and North America (0.30%, 95% UI = 0.25-0.36). Opioid dependence was estimated to account for 9.2 million DALYs globally (0.37% of global DALYs) in 2010, a 73% increase on DALYs estimated in 1990. Regions with the highest opioid dependence DALY rates were North America (292.1 per 100 000), eastern Europe (288.4 per 100 000), Australasia (278.6 per 100 000) and southern sub-Saharan Africa (263.5 per 100 000). The contribution of YLLs to opioid dependence burden was particularly high in North America, eastern Europe and southern sub-Saharan Africa. Conclusion Opioid dependence is a substantial contributor to the global disease burden; its contribution to premature mortality (relative to prevalence) varies geographically, with North America, eastern Europe and southern sub-Saharan Africa most strongly affected.